A rare case of aggressive primary pulmonary synovial sarcoma: A case report

Synovial sarcoma is a malignant mesenchymal tumour which mostly affects young adults and is mostly seen in extremities. Primary synovial sarcoma arising from the lung is rare, accounting for less than 0.5% of all lung carcinomas. Most commonly it arises from the lung followed by pleura and mediastinum. Primary pulmonary synovial sarcoma is an extremely aggressive malignant tumour that can invade adjacent organs and give distant metastasis. Histologically it is of two main types – monophasic and biphasic. IHC is a must for diagnosis following clinical examination and imaging. Here we report a case of an elderly male with right lung mass lesion infiltrating the visceral and mediastinal pleura. PET – computerized tomography (CT) guided biopsy was s/o synovial sarcoma monophasic type which was further confirmed by IHC. The multimodality treated for this includes wide resection, chemotherapy and radiotherapy. Synovial sarcoma is relatively chemosensitive though it is considered as a high grade tumour with a poor prognosis. Because of the advanced stage of the disease our patient was not a candidate for surgery and was taken up for chemotherapy. He had a survival of 6 months but had succumbed due to non – cancer related cause.

Transhiatal Chest Drainage Reduces The Frequency of Postoperative Thoracentesis In Transmediastinal Esophagectomy For Esophageal Cancer: A Retrospective Study

Background: Transmediastinal esophagectomy for esophageal cancer occasionally results in the postoperative accumulation of pleural effusion despite the preservation of the mediastinal pleura. Transhiatal chest drainage has reported utility in thoracic esophagectomy; however, its use in transmediastinal esophagectomy remains unelucidated. This study aimed to evaluate the effectiveness and safety of transhiatal chest drainage in transmediastinal esophagectomy.Methods: This retrospective study included patients who underwent transmediastinal esophagectomy for esophageal cancer from 2018 to 2020. The transhiatal chest drainage involved the insertion of a 19-Fr Blake® drain from the inferior hepatic space to the left thoracic cavity through the hiatus. The drainage group comprising 13 patients was compared with the non-drainage group comprising 13 patients in whom a transhiatal chest drainage tube was not placed during transmediastinal esophagectomy.Results: The frequency of thoracentesis in the drainage group was significantly lower than that in the non-drainage group (p = 0.03). There were no significant differences between the two groups in terms of the occurrence of other postoperative complications, duration of oxygen administration, and postoperative hospital stay.Conclusions: Transhiatal chest drainage could evacuate pleural effusion effectively and safely after transmediastinal esophagectomy. Therefore, this procedure is clinically useful in transmediastinal esophagectomy for esophageal cancer.

Extrapericardial Pleural Lipoma: A Surgical Case Report and Current Literature Review

BackgroundLipomas arising from the intrathoracic pleura are exceedingly rare. Few cases have been reported worldwide. To our knowledge, this presented case is one of the few cases reported. Here we report a single case as intrathoracic lipoma that arose from the mediastinal pleura of the left pericardium. Here the tumor was completely resected by uniportal video assisted thoracic surgery. Case presentationA 64-year-old female presented with a symptomatic left chest pain, which was confirmed to be an lipomatous tumor using computed tomography. An oval extrapericardial lipoma originating from the mediastinal pleura was resected through uniportal video assisted thoracic surgery. Pathological examination indicated a diagnosis of pleura lipoma. ConclusionThe tumor was infectious and relatively hyperemia when detected during a medical checkup. We enabled the successful tumor excision via uniportal video assisted thoracic surgery approach. Extratumoral haemorrhage was confirmed during the operation. Although intrathoracic pleural lipomas are histologically benign, careful observation and follow-up are crucial due to the possibility of recurrence.

CONGENITALABSENCE OF LEFT PERICARDIUM AND MEDIASTINAL PLEURA: A RARE INCIDENTAL FINDING DURING OPEN HEART SURGERY.

9 Year old male child planned for elective Atrial Septal Defect closure Surgery.He had a incidental Intra Operative finding of Partial pericardial defect on left side with Pericardial Herniation in left pleural cavity.

PS01.119: TO INVESTIGATE WHETHER BILATERAL MEDIASTINAL PLEURA SHOULD BE REMOVED IN I-IIA ESOPHAGEAL CANCER SURGERY

Background For thoracic segment esophageal range, Some think resect double side mediastinal pleura. other think never resection has no difference, increased complications. Methods This study used a prospective, randomized controlled study method. 213 patients with I-IIIA esophageal cancer were randomly divided into two groups. one group of 106 patients were completely removed with bilateral mediastinal pleura. Another group of 107 patients had the mediastinal pleura in the implementation; Both groups performed a thoracic lymph node dissection. we observed the incidence of pleural effusion, pulmonary infection rate, chest infection rate, OS, thoracic metastatic tumor incidence, and the postoperative review PET- CT. Results Among the 106 patients, there were 11 cases of pleural metastasis, 8 cases of chest infection and 33 cases of pulmonary infection, thoracic drainage tube pulling time averaged 3.8 days. After surgery three months, six months, one year, two years, 47 cases PET-CT are positive. an average 5-year survival rate of 47.3%. In other group, 15 patients with pleural metastases, 5 patients with chest infection, 19 in the lungs, thoracic drainage tube pulling time averaged 3.4 days. After surgery three months, six months, one year, two years, 43 cases PET-CT are positive and an average 5-year survival rate of 46,8%.. Conclusion This study is a prospective study on mediastinal pleural resection of esophageal cancer. Experimental conclusion found two groups of patients with pleural and pleural metastasis rate was not significant difference, and the chest cavity infection and pulmonary infection rate, less resection in patients with bilateral mediastinal pleura resection group is more, chest tube pull out two groups of almost the same time, there was no significant difference. Postoperative three months, six months, one year, two years PET-CT results, no significant difference in chest positive results. Patients with bilateral mediastinal pleural resection had a higher chest discomfort. In conclusion, it was concluded that there was no significant advantage in the surgical excision of bilateral mediastinal pleura in patients with esophageal cancer, and there were many complications. The sample size of this experiment is small, which is a single center study, and more large samples are needed. Disclosure All authors have declared no conflicts of interest.